Completely Confused - symptoms of HYPO but test show low normal of Free T4 and lower tsh ???

[angelinamarina]

Hi,
I am so confused.
I am 40 F, 65-75lbs overweight, exhausted, low energy, cannot remember anything, foggy brain, no gumption, etc.... (used to be a firecracker until recent years) -

I have sleep apnea, and feel dragged down and miserable most days.  I am treated and my sleep apnea doc says I am doing well as far as that is concerned.
I am not depressed.
I have had mono twice that I know of, and maybe more.
I have PCOS, and oily face/hair but dry body skin, really dry actually.
I have lost much of my h air and look like I have a receding hairline!
My hair is thin and brittle.
My arms/legs are not so overweight, but my stomach looks 7 months pregnant, which as you can imagine is not too attractive when I am indeed NOT PREGNANT.
My eyes have gotten bags!  I am not sure if this is related to whatever is wrong with me or to the added weight.
I  also take paxil (8 yrs now) for extreme panic disorder which is in remission now for years thankfully.
I have been eating right-  low calorie 1200ish plus lower carb NO SUGAR and even food journaling, seeing a dietitian, and seeing a food/eating therapist to see if I had some sort of eating problem BECAUSE I CANNOT LOSE WEIGHT.  I do not have any eating disorder and according to the dietitian/food therapist I am doing everything right BUT SHE TOLD ME I SHOULD BE EATING MORE CALORIES IRONICALLY.

I FINALLY got in to see an endocrinologist who was the rudest and most awful doctor I have ever seen.  He said that my blood test results are "normal" and that i am fat because I need to eat more like 900 calories a day.   I am 5' 9" tall, do jazzercise 3x a week, and chase after a VERY ACTIVE 5 year old, 900 calories makes me feel ill but if that is what i have to do, i will do it.  I cannot stand being overweight much longer.

Here are my results which seem to be low normal on some websites???
FREE  T 4   0.76     ng/dL
TSH  0.870  uIU/mL
Cort. 9.8    ACTH  30

If anyone has any ideas please please please share them.
THANK YOU THANK YOU THANK YOU THANK YOU!

[Ilyzium]

Hi, I wanted to mention my experience with going to an Endocrinologist. Ok, well she was nice, ran a series of tests on me and told me I was perfectly normal in the end? I was like huh? I feel like **** because I have all these symptoms of being hypo. Well, I'd already been dismissed by a few Doctor's who felt that my symptoms were attributed to depression and that I should be on antidepressants. I'm thinking it's uncaring Doctors' like yourselves that make people depressed enough to go on antidepressants!  Of course there are good Doctor's out there, but most are only trained to look at your lab results and will dismiss your symptoms if they're not in their "range". I finally decided to go the natural route and found a very good Naturopath who is now currently treating me. I was also tired of going to Doctor's and being told the "weight gain is in my head" and that we all gain weight as we age? That is only an old wive's tale!I I've always been lean and athletic, exercising rigorously and eating low fat, when all of a sudden I'd gained 40 lbs in several months! think you really need to do some digging to find the right person for you. I would also advise going that route, because they are trained to deal with the causes of everything and not just the symptoms. Also you are not just a "lab result" to them.

But I too had the same problems as you, especially the tiredness, foggy brain, no energy, and the INABILITY to lose weight! UGH! That has to be the most annoying problem! For myself when I began taking my Armour Thyroid, I only lost maybe 3 lbs, then had my hormones checked and found that I had a hormonal disorder, also extremely high levels of cortisol. Well I was given some natural hormones and altogether i lost 16 or 17 lbs last September/October. Still need to lose 20 more go down 1 clothing size and it's not budging at all, so this time I might look into another Naturopath for the weight loss. Oh yes and I also high Adrenal Exhaustion too so I'm not supposed to exercise strenuously.
Anyway good luck to you and keep us posted. :)

[DAB427]

Let me see if I can share some of what I have learned.  Your chief complaint is the inability to lose weight (mostly in your middle) and you are fatigued and tired most of the time?  You have lots of hypo symptoms?  Hypo and hyperthyroid symptoms sometimes can be very similar so when you posted your labs, what are the ranges that correspond to the numbers?

Often times when you can't lose weight, can't sleep well, you are tired during the day and carry your weight around the middle, it has to do with Cortisol.  Is the number you gave your AM Cortisol and what is the range?  If the range is like my labs (4.3-22.4), you are low in the morning, regardless of what it says.  From that point on, your adrenals are working overtime to get you through the day.  Hence, you can't lose weight, can't sleep, etc.  Also, if your adrenals are working overtime, you are not producing your sex hormones properly either.  Being 40, you could be perimenopausal.  Do you have night sweats, hot flashes or infrequent periods?

I take bioidentical hormones (estradiol and progesterone) from Women's International Pharmacy (1-800-279-5708).  They can give you a list of doctors in your area who prescribe bioidentical hormones in your area.  You may try this as this type of doctor will be more willing to treat your "whole" body.

As far as dry skin and hair loss, it can be adrenals or hypothyroid or hyperthyroid.  

First thing I would do is STOP jazzercising for a couple of weeks and give your body a break.  Then start walking (easier on your adrenals).  Take Vitamin C, B100 Complex, Fish OIl and get a new doctor.  There IS a medical reason your aren't losing weight and it's not your calories.  You need atleast 1200 calories a day in order to lose weight.  I did it on 1400.

I am sure many others have some good advice for you.  Wish you luck.

[estrelinha]

What are the units of your ACTH? I would try to repeat the thyroid tests, also the free T3.
Have you tested LH and FSH? cortisol, etc. What kind of tests the ENDO asked for (what was normal?).

[angelinamarina]

Thanks so much for your reply.  I really appreciate it.  I am looking forward to hearing if anyone has any input.

Thanks,
Angi G

[Rite760]

Hi. Firstly, anyone on here will tell you most Endos for some reason are reknowned for their rudeness and it can take ages to find a new one who shows you respect. So you're not alone there! Secondly, I'm not too good with USA results as the blood range values are different to ours here in the UK, so you'll have to wait till some of the others answer this post for help with that one. But there is one thing I can tell you and that is that my blood levels were normal for a year when I had loads of symptoms. And it is only this second year that signs in the blood have started to show. And even now my thyroid swings back and forth between normal and borderline hypo. So as everyone here always told me for which I am eternally grateful, trust your own instincts, you know your body, if it doesn't feel right make the docs listen. And get a 2nd opinion. Hope this helps.